NPI | 1164745659 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-45913) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO 1378) |
Enumeration Date | 2010-03-11 |
Last Update Date | 2022-06-09 |